Saturday, January 30, 2010

Battling the system: A patient's tale

A cancer patient has saved thousands of dollars by tracking his bills, pleading his case and working the phones, demonstrating how to be a smart medical consumer.  From the wall Street Journal.

Alex comments:  A good article for anyone who wants to know how to handle the bills of medical care.  

There is also a 2nd article from the Wall Street Journal about programs that can help ease the monetary burden of medical care.  The article Help With Medical Bills can be found by clicking here.

A diagnosis of cancer or other serious disease can be devastating to one's financial as well as physical health -- even for people with insurance. But there are a handful of programs that can help ease the monetary burden.
The programs, run mainly by nonprofit and charitable groups, offer financial aid to patients with specific life-threatening or chronic diseases to help cover the cost of co-payments, deductibles and other medical expenses. Patients usually must meet specific income and treatment guidelines.
Patients typically are referred to the programs by the financial counseling or patient-advocate offices of big hospitals and treatment centers. But you also can seek them out online.
Cutting Cancer-Care Costs
The CancerCare Co-Payment Assistance Foundation (at 1-866-552-6729 or helps eligible patients cover the cost of insurance co-payments for treatment of specific cancers. The program, founded in April 2008, now lists seven diagnoses eligible for assistance: breast cancer, colorectal cancer, head and neck cancer, non-small cell lung cancer, pancreatic and renal cancer and glioblastoma.
Some diseases have a $10,000 annual limit on aid, others have a $5,000 limit, says John Rutigliano, chief operating officer of nonprofit CancerCare. Most people who qualify receive between $2,500 and $5,000.
He says these days more employees are bearing a larger share of the cost of care, with higher co-pays and deductibles.
Since the CancerCare program began, about 7,000 people have applied for co-pay assistance, and about 80% of them have received aid. Half of those who received aid were on Medicare and the other half were privately insured.
The foundation rejects less than 7% of applications, mostly because applicants' income exceeds guidelines. The cutoff for assistance is 400% of the federal poverty level -- slightly above $43,000 for an individual and $58,000 for a family of two.
Nancy Francisco of Crystal Falls, Mich., received financial help from CancerCare when she was diagnosed with glioblastoma, a type of malignant brain tumor, early in 2009.
Mrs. Francisco, a 45-year-old registered nurse and electronic medical records technician, became disabled as a result of the illness and treatment. Her husband is her full-time caregiver. She continued her health-insurance coverage under her former employer's Cobra plan, but out-of-pocket expenses for treatment exceeded $10,000. CancerCare helped her with a $10,000 grant, says the mother of three, which helped cover co-pays for chemotherapy and IV transfusions.
"I couldn't believe there was help," says Mrs. Francisco, who learned of the program from her hospital social worker and pharmacist, who also helped her fill out the application.